Dialectical Behavior Therapy (DBT)
Find balance in your life with DBT
We can come to rely on problematic behaviors to cope with difficult situations in our lives. While these behaviors may ease some of the pain at the moment, they do not help us in the long term.
Dialectical Behavior Therapy (DBT) is an evidence-based treatment that emphasizes finding the balance between accepting reality as it is and changing unwanted behaviors, emotions, thoughts, and responses.
DBT Treatment Modes
DBT uses three types of therapy approaches to teach the four skills discussed below. Some believe this combination of techniques is part of what makes DBT so effective.
Individual Therapy
DBT individual therapy looks similar to standard therapy and involves One-on-one sessions with a DBT-trained therapist where learned behavioral skills are adapted to personal life challenges.
DBT individual therapy looks similar to standard therapy. It is usually one time per week for about 45 minutes. However, it is a more structured approach that organizes the session around your established goals. The goals encompass a 3-level hierarchy:
(1) High-risk target behaviors, such as cutting, suicidal thoughts, substance usage, and disordered eating.
(2) Treatment-interfering behaviors, such as lateness, absences, and environmental constraints
(3) Quality of life goals, such as employment, education, health, and relationships. The client keeps a diary card during the week to keep track of the goals to improve upon areas of difficulty and further foster strengths.
Phone Coaching
Coaching is probably one of the most misunderstood aspects of DBT. Coaching involves phone/text contact with your individual therapist during the week, providing in-the-moment opportunities to implement DBT skills with their guidance.
While it would certainly be appropriate to reach out to your therapist in a crisis, its purpose goes far beyond crisis intervention. Rather, coaching is primarily meant as a means to promote skill generalization to the client’s day-to-day life.
Thus, when the client is facing a distressing situation, it is encouraged to first attempt to utilize DBT skills to manage the situation. If successful, the client is encouraged to share these successes with the therapist. If still struggling, the client is welcome to request guidance in using skills to manage the problem.
At the beginning of therapy, your individual therapist will inform you what days and hours they are available for coaching, and what to do when the therapist is not immediately available. Coaching will often taper as the treatment proceeds and the client becomes more skilled.
Group Skills Training
Learn and practice DBT skills in a group setting, talking through scenarios with other people. This is a key component of DBT.
DBT Group Skills
At mind body seven, a DBT skills group module consists of weekly sessions for a period of either 6 or 8 weeks.
Teen DBT groups run for 6 weeks, while our Adult DBT groups run for 8 weeks. Each 6 or 8-week module always includes the core skill of Mindfulness, along with one of the other three skills of either Distress Tolerance, Emotion Regulation, or Interpersonal Effectiveness.
Mindfulness:
These skills are fundamental to DBT and are often referred to as core skills. They teach how to bring awareness to everyday living. Mindfulness consciously brings attention to feelings, thoughts, body sensations, behaviors, and events without judgment. It is the opposite of rejecting, suppressing, or avoiding current experiences.
Core Mindfulness Skill Exercise
Mindfulness skills help you slow down and focus on using healthy coping skills when you are in the midst of emotional pain. The strategy can also help you stay calm and avoid engaging in automatic negative thought patterns and impulsive behavior.
Sample exercise:
It is important to pay attention to your breath and you can do this by taking note of the sensation of inhaling and exhaling or by watching your belly rise and fall as you breathe.
Distress Tolerance:
These skills center on accepting and coping with pain and distressing life events. They focus not on changing the moment, but on accepting the current situation and finding ways to get through it without engaging in problematic behavior.
Distress tolerance Skill Exercise
Distress tolerance techniques help prepare you for intense emotions and empower you to cope with them with a more positive long-term outlook.
Sample exercise:
There are many things you can do and they often involve being active, so if you're inside, go outside, if you're sitting, get up and walk around and if you have them, run up and down the stairs. The idea is to distract yourself by allowing your emotions to follow your body.
Emotion regulation:
Sometimes we are unable to modulate the painful emotions that underlie impulsive, risky behaviors. These skills include understanding current emotions, identifying obstacles to changing emotions, checking facts related to emotional reactivity, problem-solving, and increasing positive emotions.
Emotion regulation skill exercise
Emotion Regulation lets you navigate powerful feelings more effectively. The skills you learn will help you to identify, name, and change your emotions.
Sample exercise:
This might be slightly difficult at first but you can try to identify how you're feeling and do the opposite. If you are feeling sad and want to withdraw from friends and family, you can make plans to see your loved ones.
Interpersonal effectiveness:
Interpersonal relationships can bring joy and happiness and cause fury or despair. These skills help teach us how to get what we want and need in life while maintaining relationships and self-respect. They include strategies for asserting our needs, saying no effectively, and coping with conflict. These skills help maintain friendships, decrease social isolation, and end destructive relationships.
Interpersonal effectiveness skill exercise
Interpersonal effectiveness helps you to become more assertive in a relationship while still keeping the relationship positive and healthy. You will learn to listen and communicate more effectively, deal with challenging people, and respect yourself and others.
Sample exercise:
Use the acronym GIVE to improve relationships and positive communication:
Gentle. Don't attack, threaten, or judge others
Interest. Show interest with good listening skills (don't interrupt someone else to speak)
Validate. Acknowledge the other person's thoughts and feelings
Easy. Try to have an easy attitude (smile often and be light-hearted)
Is DBT for Me?
DBT can be an effective way of treating many types of mental health disorders such as borderline personality disorder, depression, anxiety, bipolar disorder, eating disorders, post-traumatic stress disorder, suicidality, and self-harm. DBT teaches concrete skills to decrease suffering, increase coping abilities, and promote fulfillment. It has shown to be a powerful tool for teens and adults and we offer groups for both.
